Offshore concerns blog

I mentioned this a few messages below, but the blog has its first post. I am NOT supporting any Ad things on there and will not be making anything off this.

If you have a link that would be useful to others to write their gov't reps, companies, news sources, etc, feel free to post them or e-mail me so i can get them up there. I am also looking for any news stories or any information we can get. One way or the other, we might be able to make a difference.

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They are smart , and that is why the jobs are going to them! Jobs don't make people smarter; smart people do their jobs well. If you don't believe this then you must question the wisdom of the American MTSOs and companies that outsource. As I have said before, all Indian MTs are not bad and all US MTs are not good. I've seen excellent quality from India and poor quality from the US - that's the other side of the story which none of you wants to see, let alone admit.

This is why I call US MTs insular. If you will only look outside of your own town/state/country you will see how the world has changed and the so-called developing countries have advanced in many ways.

The problem with the US is it has been functioning too long in a cocoon, sheltered and protected. But with the coming of the global age, competiton has become fierce and jobs are moving overseas and it is now finding it difficult to cope in this new business climate.

You say "sadly" because it affects you but have you ever wondered how Indians like it when American companies dump poor quality goods on them and Indian businesses have to shut shop because they can't bear the competition? Of course most of you would not have heard that pesticides were found in bottles of a premier American brand of soft drink sold in India!

Instead of treating "offshoring" as some terrible phenomenon, it is high time US MTs learned to accept the situation because this is the New Age Economy where everything is decided in competition.

As always, if you have concerns/questions/comments regarding DSG, I have an open door policy. Please feel free to contact me at kdenson@dsg-inc.net.

EMR and voice recognition has put me out of a job. On my former job, there was one other Transcriptionist besides me. Because she had been there longer, she got what was left over after most of the docs jumped on the voice recognition bandwagon. They use Dragon Naturally Speaking. I have seen it at work myself and it is quite accurate. There is no editing being done on their work. Now, I'm doing a job that is just that, a JOB. I enjoy transcribing and am looking for another job, but MT jobs seem to be few and far between where I am. I can't get high speed internet where I live, so most services are out. I may move onto a different career if something doesn't come around soon. I thought about legal transcription. Anyone have experience with that?

Did any of you watch the special the other night on identity theft? I think it was maybe on Dateline. If so, you heard them say the identity theft ring reaches far beyond the shores of the US. It involves many of the countries that are receiving outsourced transcription work.

The first thought that came to mind when watching that was our medical records. I often have dictation that gives me a SSN and DOB. I also often have dictation on a new patient giving me other details, such as where the individual works, how many children they have, etc. I always get their height, weight and race. With these details, the individuals being outsourced to have everything they need to supply a terrorist or identity theft ring information to enable them to pose as someone else. This is very frightening to me!

What do we do? How do we wake America up to what we're facing? Sure, we can write our elected officials, but you all know as well as I do that such correspondence falls upon deaf ears. Does anyone have any suggestions on where we go from here? At this point, it isn't only about losing our jobs, its about national security.

I don't kow what they could do to help you RE: Katrina but companies need to verify the NEED to cut back or do it across the board, at least in the department / job level. I worked for this company for 6 yr & had several cuts in my take home. The platforms used became slower & slower because of the amazing amt of data in the programs. I had 3 gig memory & STILL took forever & you aren't making a dime for that several minute while a report is sending & the next coming in & then doing the demographic page.

I've been trying to find out if there was anything of that investigation - I never did get that paper that so many other employees got. And I had a definite beef.

I just looked at your transcription blog. I love it! I had added to my favorites. What a great idea.

Is there anything at all an MT can do when you have grave concerns about the care a patient is receiving? I know the answer to this is probably no, but I am so completely frustrated with my one of "my" doctors right now. I know that one of his patients is not receiving the proper care, and I am really worried for this patient. I wish I could contact the patient's mother and let her know my concerns, but I know that is not allowed and I would be fired for doing so. I know that I'm not anywhere near as smart as a doctor, but my son has the same condition that this patient does and I know that the patient is not receiving the proper care or even the correct diagnosis. It is hard to go into all of the details for confidentiality reasons. I just know, 100% sure, that this patient deserves better care than he is receiving.

Sometimes the virtual world that we work in is great, and other times it really stinks. If I were working in the doctor's office I could gently share my concerns (maybe I would still be fired but I could give it a shot). Here in this virtual world where the doctors don't even know I exist I can do absolutely nothing.

or do you have one? It would be a place for you to write like you have here. Just wondering.

who says what he REALLY thinks about the JCAHO. Funny, I found it on Google when I typed in JCAHO and q.i.d. since I wasn't sure what to do about q.i.d. ........

The Death Star of American Medicine

I wish I had written this (JCAHO Unplugged; registration required), because it gives voice to the feelings that I (and probably 99% of the physicians in this country) have about the Death Star of American medicine -- JCAHO. A few excerpts (emphasis is mine):

That is why it really upsets me to watch the JCAHO people walk through my hospital like they were navigating a toxic waste dump. What upsets me even more is the utter paralysis of normal activity that occurs months before their visit and the huge sums of money spent on mock drills and consultants to prepare for the JCAHO invasion. JCAHO (the Joint Commission on Accreditation of Healthcare Organization) arouses more fear in hospitals than MRSA gone wild, and their "visit" has a greater institutional paralytic effect than circulating a neuromuscular depolarizing agent through the ventilation system.

A few unsigned verbal orders, or an anesthesiologist carrying a syringe of Anectine in his or her scrubs, or not locking up I.V. bottles of normal saline will result in conditional or provisional approval, and failure to take remedial action within 30 days may result in the death penalty, which for the hospital means bad PR, and more significantly, loss of all federal money. That's right, you can get the chair for parking tickets in the JCAHO world.

It doesn't matter that the hospital admits 50,000 patients a year, saves countless lives and performs daily miracles. Write q.i.d. twice and you can get your liver transplant someplace else.

A response by Russell Massaro, MD, FACP, Executive Vice President Accreditation and Certification Operations, JCAHO, follows Dr. Cossman's screed. The only thing I can say about it is that he makes clear that unannounced surveys will be forthcoming in 2006. Oh, joy!

A lot of the press in the past few days has been discussing issues such as oversight, accountability, and clearly expressed legal authority. JCAHO operates without any real semblence of these niceties, and does so with all the subtlety of a bureaucracy run by Darth Vader. Watching hospital administrators lose bowel and bladder control the minute a JCAHO inspection is brought up has always reminded me of Vader's underlings wilting in his presence --- and for good reason. Without the JCAHO seal of approval, they cannot operate an otherwise well-run, caring facility. The organization, as it was originally intended, was designed to ensure a basic level of safety for all hospitals. It has now become yet another "certifying" agency which must come up with new "critical" problems to fix in order to ensure its ongoing existence (those of you who have gone through the most recent mental masturbatory experience of banning QD and QID in orders know what I mean). What is most galling to me, however, is that hospitals must fork over a hefty sum for these frequent torture sessions, and the inspections are done not by practicing physicians or nurses, but by folks who long ago gave up the difficulties of actually caring for patients for the safety of a clipboard to hide behind.

Maybe I have my metaphors mixed up --- JCAHO comes in like the Death Star, but leaves no room for different institutions to solve problems in their own way. The JCAHO mantra can really be translated as "Resistance is futile. You will be assimilated!" As a result, I suppose JCAHO is really The Borg.